July 15 -21, 2019

The Northwest Region Healthcare Coalition’s next meeting is the Cardinal Resolve Table Top Exercise on August 15th. The Table Top Exercise is the first of two joint exercises by VDH and VHHA. Please see the flyer below for more information.


1. Save the Dates

Upcoming exercises: We will be participating in a Joint VHHA and VDH Table Top Exercise August 15th in-place of our regional coalition meeting. This exercise is a lead-up to the Joint Full Scale Exercise October 23rd. Questions regarding the upcoming exercises, please contact our Exercise and Training Coordinator, Matt Cronin. Please see the Cardinal Resolve TTX Flyer for more details.

Upcoming regional training: The Coalition will host the MGT – 349 Pediatric Disaster Response and Emergency Preparedness course November 18 – 19, 2019 in Harrisonburg, VA. Questions regarding upcoming training, please contact our Exercise and Training Coordinator, Matt Cronin. Please see the link for more details.

2. Clinical Advisor

As part of expanding the regional coalition collaboration, the Northwest Region Healthcare Coalition will seek to hire a part-time physician to serve as a clinical advisor. The clinical advisor will be asked to:

  • Provide clinical leadership to the coalition and serve as a liaison between the coalition and medical directors/medical leadership at health care facilities, supporting entities (e.g., blood banks), and EMS agencies.
  • Review and provide input on coalition plans, exercises, and educational activities to assure clinical accuracy and relevance.
  • Act as an advocate and resource for other clinical staff to encourage their involvement and participation in coalition activities.
  • Assure that the coalition mass casualty/surge plans provide for appropriate distribution (and re-distribution) of trauma patients to avoid overloading single centers whenever possible and work with health care facilities to understand their capabilities and capacity.
  • Assure that subject matter experts are available, and a process exists to support secondary transfer prioritization in specialty surge (e.g., burn, pediatric) mass casualty situations (i.e., identify which patients are a priority to transfer to specialty care centers when adequate transportation or inpatient resources are unavailable).
  • Engage health care delivery system clinical leaders to provide input, acknowledgement, and understanding of their facility and regional strategic and operational roles in acute medical surge planning to include CBRNE, trauma, burn, and pediatric readiness and response.


3. Check out our new area on our website titled “Spotlights”

There you will find a monthly update showcasing best practices, collaboration, and highlighting the great work everyone is doing to become better prepared for emergencies or disasters.

4. Memorandum of Understanding
We are pleased to announce that the Northwest Region Healthcare Coalition continues to receive requests to sign a Memorandum of Understanding (MOU) between the coalition and non-hospital facilities. The MOU is designed for healthcare facilities that are not classified as an Acute Care or Critical Access hospital, and it is good for five (5) years before it will need to be renewed. If your organization resides within the Northwest Region and you have not signed the MOU, you can contact either the Regional Coordinator or the Medically Vulnerable Populations Coordinator to find out more details.

We are expanding our outreach to healthcare agencies within the region as a way of offering assistance to you and your organization. We ask for everyone’s help to spread the word by talking with your colleagues about the Northwest Region Healthcare Coalition. You can contact us by clicking the Contact Us tab on our website.


Click here to access our website. Don’t forget to visit the Events calendar for upcoming training and exercise events.


We have developed a one page understanding of the regional coalition that can be shared between coalition partners. Please click here to view the regional “one-pager”.

 Virginia Hospital & Healthcare Association

Virginia Department of Health


 Assistant Secretary for Preparedness and Response


Assistant Secretary for Preparedness and Response Technical Resource,                                                                                                                             Assistance Center, and Information Exchange

Hospital Preparedness Program



The HPH Sector Highlights – Healthcare Supply Chain Edition is a monthly email produced by the HHS ASPR Division of Critical Infrastructure Protection (CIP) on behalf of the HPH Sector Partnership. It includes updates with information related to the healthcare supply chain.

The Healthcare and Public Health Sector Highlights

Healthcare Supply Chain Edition

July 2019

Building a Better Network: Four Ways to Make Critical Connections Your Facility Could Rely on During a Medical Supply Shortage

Check out the third post in ASPR CIP’s blog series Anticipating and Managing the Challenges Associated with Supply Shortages. This post is titled Building a Better Network: Four Ways to Make Critical Connections Your Facility Could Rely on During a Medical Supply ShortageThe series is designed to highlight actions that healthcare organizations can take to protect patient health in the event of a supply shortage. To learn more, check out the first two posts in this series: Four Ways to Plan to Protect Patient Health in a Medical Supply Shortage and Exhaustion in the ED and Beyond: Managing Supply Shortages and Staff Fatigue in Healthcare Facilities.

How it Works: The Supply Chain in Disasters and Disease Outbreaks

When a disaster causes facility damage, transportation issues, power outages, and related generator fuel shortages, the pharmaceutical supply chain is threatened. This web page, developed by HPH SCC member Healthcare Ready, details in text and illustrations how private companies, nonprofits, and the government collaborate in the wake of disasters to protect and stabilize the healthcare supply chain. It includes an interactive graphic to view more information about the supply chain during disasters and disease outbreaks. (Link)

In Disaster Response, Health Supply Chain Egos Melt Away

“A speedy post-hurricane return to normal requires competitors to become collaborators to effectively manage inventory and cold chains.” This piece from Supply Chain Dive highlights how different organizations within the healthcare supply chain can come together as collaborators in response to a disaster. (Link)

HDA to Host 2019 Traceability Seminar in Washington, D.C.

Implementation of the Drug Supply Chain Security Act (DSCSA) continues to transform the pharmaceutical supply chain. As the industry works toward the law’s 2023 finish line, HDA’s annual Traceability Seminar brings together healthcare supply chain leaders to learn more about upcoming DSCSA implementation milestones as well as innovative approaches and lessons learned as distributors, manufacturers and dispensers implement serialization and traceability technologies to further preserve the safety and security of the healthcare supply chain.

This seminar, scheduled for October 21st-23rd in Washington, D.C., is designed for pharmaceutical distributors, pharmacies and supply chain practitioners responsible for the implementation of traceability strategy, systems and processes in the healthcare supply chain.

Credit: Centers for Disease Control and Prevention


Credit: U.S. Food & Drug


Credit: Centers for Medicare and Medicaid Services


         U.S. Department of Homeland Security 

Federal Emergency Management Agency


Virginia Department of Emergency Management

Course Offerings

2019 Mass Care Symposium August 8, 2019. The day will focus on efforts to provide Mass Care services during Hurricanes Matthew and Florence, as well as best practices and pitfalls within Inclusive Planning.

CVEMA 2019 Mass Care Symposium

ICS 400 Advanced Incident Command Systems course is scheduled for August 28-29, 2019. Please see flyer for additional details.

Course Announcement ICS 400 Madison

ICS 300 Intermediate ICS for Expanding Incidents course is scheduled for September 14-15, 2019. Please see flyer for additional details.

Course Announcement ICS 300 Shenandoah

MGT-418 Readiness: Training Identification and Preparedness Planning (RTIPP) course is rescheduled for September 23-24, 2019. Please see the flyer for additional details.     

MGT418 Course Announcement – Spotsylvania VA

PER-335 Complex Coordinated Attacks (CCA) course is scheduled for October 15-16, 2019. Please see the flyer for additional details.

PER335 Course Announcement – Fredericksburg, VA

1. Smaller Healthcare Providers Struggling to Implement Healthcare Cybersecurity Best Practices

Smaller healthcare providers are more likely to struggle at following cybersecurity best practices while large healthcare providers tend to have mature, sophisticated defenses, according to a KLAS and CHIME study and cited by the HIPAA Journal.

KLAS and CHIME examined the responses to the 2018 Healthcare’s Most Wanted survey that was issued to around 600 healthcare providers.

Responses showed that large healthcare organizations are more proactive and conduct regular vulnerability scans. Smaller healthcare organizations rely on penetration tests to identify vulnerabilities.

Large healthcare providers were also more likely to have governance, risk management and compliance committees. Smaller healthcare organizations were less likely to use network segmentation and multifactor authentication.

HSS formed a task force in 2015 to help healthcare providers manage risks. Here are nine principles for providers to follow:

  1. Email protection systems.
  2. Endpoint protection systems.
  3. Access management.
  4. Data protection and loss prevention.
  5. Network management.
  6. Vulnerability management.
  7. Incident response.
  8. Medical device security.
  9. Cybersecurity policies.

Source: Mackenzie Garrity of Becker’s Health IT & CIO Report

2. National Health Security Preparedness Index 2019

The 2019 National Health Security Preparedness Index (NHSPI) shows the United States scores a 6.7 on a 10-point scale for preparedness. That’s a 3.1 percent improvement over the 2018 Index and 11.7 percent improvement since the Index began in 2013. The overall growth is good, but work is obviously needed.

The 2019 NHSPI (PDF, 2.1 MB) tracks 129 data points to determine how well the nation and individual states are prepared to handle widespread health emergencies. Not all data collected is directly medical; for example, the Index also looks at the condition of bridges.
The national score has climbed marginally in the past few years as some states work to improve their capabilities. Overall:

  • Incident and Information Management scored highest at 8.7 out of 10.
  • Healthcare Delivery scored lowest at 4.9.
  • The number of states above the national average dropped to 11 in 2019 from 22 the previous year.
  • 39 percent of the population reside in states with below-average health security.

Each state’s data is available and provides a breakdown of the measures and the state’s scores as well as where data is lacking. This information may help identify areas for improvement unique to each state and provides a defensible and persuasive data source to use when discussing policy changes and budget with state officials.

Source: NHSPI

3. Legacy Systems in the Healthcare Industry

Healthcare continues to increase the number of IoT [Internet of Things] and medical devices used in the healthcare setting, with the majority of devices operating on legacy systems. By 2020, 70 percent of all healthcare devices will be operating on Windows systems, which will no longer be supported by Microsoft beginning January 14.

A lot of organizations aren’t equipped to confront hardware hacking mainly because the technologies that they employ may continue to pose security vulnerabilities even at the end of their life cycles.
Source: HC3

4. ‘There’s nothing to give them’: Patients, pharmacists scrounging for EpiPens

Patients and pharmacists nationwide are grappling with a persistent shortage of Mylan’s EpiPen, forcing some to travel great distances or go through several hoops to access the lifesaving allergy treatment, according to Bloomberg.

EpiPens have been difficult to obtain since at least May 2018, when the FDA alerted the public to the shortage. While generic alternatives are available, they are often hard to secure due to uneven distribution, pushback from insurers on covering the similar treatment and patient uneasiness with unfamiliar products.

Patients across the nation are going to great lengths to obtain the lifesaving drug. Boston resident Justin Klaassen drove 45 minutes outside the city to find EpiPens for his 7-year-old daughter after calling every pharmacy within 10 miles.

“My family has enough money to buy one with insurance, you know, and even two, because you want one at school and you want one at home,” Mr. Klaassen told Bloomberg. “But there are families out there who can’t even afford one, and then you have the problem finding them.”

The inventory problems can be traced to September 2017, when Pfizer’s Meridian Medical Technologies division, which manufacturer of EpiPen for Mylan, received a warning from the FDA about failing to investigate faulty injectors. The current shortage is still attributed to “manufacturing issues and delays.”

Kim Bencker, a  Pfizer spokesperson told Bloomberg that EpiPen’s have a “highly complex and technical” manufacturing process and that supply shortages will continue over the next few months. 

Pharmacists across the country are also struggling to get their hands on EpiPens.  Carter High, owner of Best Value Rhome Pharmacy in Texas, told Bloomberg its wholesaler has pushed back the date when more injectors would be available several times.

“As a parent, I look at that and think, God I wish I could help them,” Mr. High told Bloomberg. “I can’t. There’s nothing to give them because I just can’t get it.”

He added that he often tells patients to keep expired EpiPen’s because it is better “to have something than nothing.”

Alternatives are available, but pharmacists say they are hard to come by. 

Earlier this year, Teva launched its generic rival to EpiPen. However, a New Jersey pharmacist Eklavya Lalwani told Bloomberg. “I’ve never actually seen Teva’s product in the marketplace.”

Source: Alia Paavola of Becker’s Hospital Review

5. Trump issues executive order on kidney care: 6 notes

President Donald Trump issued an executive order July 10 detailing plans to transform kidney care in the U.S.

Six quick things to know about the order:

1. The order laid out three specific goals:

  • Reduce new cases of end-stage renal disease by 25 percent in 10 years. Currently, more than 726,000 Americans have ESRD and more than 100,000 Americans begin dialysis every year, according to the Trump administration.
  • Increase the percentage of ESRD patients who receive dialysis at home or a kidney transplant to 80 percent by 2025. About 12 percent of patients undergo dialysis at home.
  • Double the kidneys available for transplant by 2030. Almost 100,000 people are waiting for a transplant.

2. To accomplish these goals, CMS’ innovation center unveiled four optional Medicare payment models. The models aim to use incentive payments to improve providers’ management of kidney disease and prevention efforts.

3. CMS also released a proposed rule for a mandatory model called “ESRD Treatment Choices,” which would target dialysis providers and incentivize them to move treatment into patient homes.

4. The administration plans to transform the organ donation and transplant process. This includes plans to increase financial support for organ donors.

5. To improve kidney supply, the order includes provisions to encourage artificial kidney development. It plans to launch prize competitions through a public-private partnership to accomplish this goal.

6. HHS will launch a public awareness campaign about kidney disease.

Source: Emily Rappleye of Becker’s Hospital Review

6. Senate passes blockchain bill: 3 things to know

The U.S. Senate Commerce, Science and Transportation Committee approved a blockchain bill last week that aims to promote the technology, according to a CNET report and cited by Yahoo Finance.

Three things to know:

1. The Blockchain Promotion Act is bipartisan legislation that would require the U.S. Department of Commerce to form a working group that will define what “blockchain” is. The bill also has support within the House of Representatives.

2. Members of the Blockchain Working Group will also provide recommendations on the applications of blockchain, including how federal agencies can use it.

3. Members of the blockchain group will be both governmental and non-governmental stakeholders, including information and communication technology manufacturers, suppliers, software providers, service providers, vendors and subject matter experts.

Source: Mackenzie Garrity of Becker’s Health IT & CIO Report